Headstart Speech & Behaviour Clinic Ltd

Updated 5 January 2023

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with children using the service and staff.

Inspection team

One inspector, a specialist professional advisor who is a registered nurse and an Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to children living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager. We also spoke with parents/carers’. We reviewed a range of records. This included five children’s care records. A variety of records relating to the management of the service, including policies and the quality of the service were reviewed.

This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with parents/carers’ using the service and staff, and electronic file sharing to enable us to review documentation. Inspection activity started on 10 June 2022 and ended on 21 September 2022.

Updated 5 January 2023

About the service

Headstart Speech & Behaviour Clinic Ltd is a domiciliary care agency providing personal care support children and young people with learning needs aged 2-17 in their homes. At the time of our inspection there were 25 children using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most children take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic children and providers must have regard to it.

Right Care

The registered manager did not fully demonstrate they understood and implemented infection prevention and control practices to ensure reduced risks from infection. Staff had not completed infection control training. The registered manager employed suitably skilled and experienced care workers to provide assessed care and support for children. Staff understood the provider’s safeguarding processes. They were trained in how to identify abuse and what actions they would take to protect children from potential harm and to report any concerns they had about children’s safety. Staff promoted equality and diversity in their support for children and parents/carers' and understood and respected their cultural needs.

Right Support

Children received care and support that met their individual needs. Children were supported by their parents/carers’ with their medicines when this was needed. Children and their parents/carers’ were involved in their care and support assessments and were asked for their views of the service, and they gave their opinions and views freely. However, we found that some risk assessments required a little further detail on risk management. Staff supported children to achieve good care, health and wellbeing outcomes and liaised with health care services when this was required.

Right culture

The registered manager reviewed and monitored the service and there were ongoing improvements to the service delivery. The provider had systems in place for children, their parents/carers’ and staff to provide feedback about the service and the quality of care. Relationships were built between the service and health, education and social service professionals. This working partnership helped staff to receive appropriate advice about children's care and support needs. Staff were aware of best practice guidance for supporting children with a learning disability and/or autistic children.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 3 November 2020, and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made three recommendations about risk management planning, infection prevention and control processes and quality audits.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.